National Provider Identifier [NPI]: |
1497848055 |
Last Name Of The Provider |
DEAN |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11212 STATE HIGHWAY 151 |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782514498 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
113 |
Number Of Services |
1351 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
289591 |
Total Medicare Allowed Amount |
106578.44 |
Total Medicare Payment Amount |
78396.38 |
Total Medicare Standardized Payment Amount |
84233.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
233 |
Number Of Medicare Beneficiaries With Drug Services |
87 |
Total Drug Submitted ChargeAmount |
3896 |
Total Drug Medicare AllowedAmount |
493.88 |
Total Drug Medicare PaymentAmount |
387.12 |
Total Drug Medicare Standardized Payment Amount |
387.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
110 |
Number Of Medical Services |
1118 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
285695 |
Total Medical Medicare Allowed Amount |
106084.56 |
Total Medical Medicare Payment Amount |
78009.26 |
Total Medical Medicare Standardized Payment Amount |
83846.19 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
117 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
80 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3167 |